Demographic and clinical characteristics of children who were hospitalized and followed due to seizures

Abstract

Aim: Seizure is the most common neurological disorder of childhood. The causes of seizures in childhood, especially febrile convulsions (FC), is still not fully elucidated. In addition, diagnosis, follow-up and treatment are still controversial. In this study, we aimed to investigate the clinical/demographic features, laboratory results, electroencephalography and neuroimaging findings of children who were hospitalized and followed due to seizures.
Methods: This retrospective cohort study included 737 patients who were hospitalized and followed up due to seizures in the pediatric neurology department. Clinical features and laboratory results of the patients were evaluated.
Results: Among all, 53.1% of the patients who had febrile convulsions were males, 46.9% were females, and the mean age was 20.68 (5) months. The most important risk factors in febrile convulsion were positive family history (38.4%) and iron deficiency (42.9%). The most common source of infection was viral upper respiratory tract infections. While cerebrospinal fluid evaluations were normal in patients with ordinary febrile convulsions, that of 30 patients with complex febrile convulsions were coherent with meningitis. 437 patients were hospitalized with the diagnosis of epilepsy, among which 54.3% were males, and 45.7% were females. The mean age was 65.8 (54.8) months. Generalized tonic-clonic seizures were most common, while idiopathic epilepsy was the most frequently observed type. The most common risk factors in epilepsy patients were positive family history (26.2%), febrile convulsion (26.8%), and cerebral palsy (8.2%).
Conclusion: In this study, febrile convulsion and idiopathic epilepsy were the most determined causes of pediatric convulsion. Kinship marriage and positive family history are both the most important risk factors in febrile convulsions and epilepsy. Children with focal FC should be followed closely due to increased risk of epilepsy. 

Keywords

• Febrile convulsion
• Seizure
• Epilepsy

Nöbet nedeni ile yatırılan ve takip edilen çocuk hastaların demografik ve klinik özellikleri

Öz

Amaç: Nöbet, çocukluk çağının en sık görülen nörolojik bozukluğudur. Çocukluk çağında nöbetlerin, özellikle febril konvülsiyonların nedenleri hala tam olarak aydınlatılamamıştır. Ayrıca tanı, takip ve tedavi halen tartışmalıdır. Bu çalışmada, nöbet nedeniyle hastaneye yatırılan ve takip edilen çocukların klinik özellikleri, laboratuvar sonuçları, elektroensefalografi ve beyin görüntüleme bulguları, tedavi yöntemleri ve demografik özelliklerinin araştırılması amaçlandı.
Yöntemler: Bu retrospektif kohort çalışmaya pediatrik nöroloji servisinde nöbet nedeniyle yatırılarak takip edilen 737 hasta dahil edilmiştir. Hastaların klinik özellikleri ve laboratuvar sonuçları retrospektif olarak değerlendirildi.
Bulgular: Hastaların 245’i febril konvülziyon, 437’si epilepsiydi. Febril konvülziyon geçiren hastaların %53,1’i erkek, %46,9’u kız, ortalama yaşları 20,6(5)aydı. Febril konvülziyon hastalarında en önemli risk faktörleri pozitif aile öyküsü(%38,4) ve demir eksikliği(%42,9) olarak belirlendi. En sık saptanan enfeksiyon kaynağı viral üst solunum yolu enfeksiyonlarıydı. Basit febril konvülziyon geçiren hastalarda beyin omurilik sıvısı değerlendirmeleri normalken, komplike febril konvülziyon geçiren 30 hastada menenjit ile uyumluydu. Epilepsi tanısı ile 437 hasta yatırılmıştı. Epilepsi hastalarının %54,3’ü erkek %45,7’si kadındı ve yaş ortalaması 65,8 (54,8) aydı. En sık jeneralize tonik klonik nöbetler görülmüştü ve en sık epilepsi tipi idiyopatik epilepsiydi. Epilepsi hastalarında en sık risk faktörleri pozitif aile öyküsü (%26,2), febril konvülziyon geçirme (%26,8) ve serebral palsiydi (%8,2).
Sonuç: Bu çalışmada çocukluk çağı nöbetlerinde en sık saptanan etiyolojik nedenler febril konvülziyon ve idiyopatik epilepsidir. Akraba evlilikleri ve pozitif aile öyküsü hem febril konvülziyonlarda, hem de epilepsi de en önemli risk faktörleridir. Fokal febril konvülziyon geçiren hastaların epilepsi gelişimi açısından yakın takibe alınmalıdır. 

Anahtar Kelimeler

• Febril konvülsiyon
• Nöbet
• Epilepsi

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